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The Pupillary Response in Traumatic Brain Injury: A Guide for Trauma Nurses

Adoni, Andrea BSN, RN, CCRN, CEN, EMT; McNett, Molly PhD(c), MSN, RN

doi: 10.1097/01.JTN.0000318921.90627.fe

Traumatic brain injuries (TBIs) affect more than 1.4 million Americans annually. Trauma nurses caring for these patients routinely perform serial neurologic assessments, including pupillary examinations. While trauma nurses are likely familiar with basic components of the pupillary examination, some confusion about more specific aspects of the examination and the physiologic basis of the pupillary response may still remain, particularly as it pertains to patients with TBI. Therefore, the purpose of this article is to identify the key components of a pupillary examination and its associated physiologic response. A case study is provided to illustrate the application of this information among patients with TBI.

Andrea Adoni, BSN, RN, CCRN, CEN, EMT, is Flight Nurse Specialist, Cleveland Metro LifeFlight; MetroHealth Medical Center, and ACNP student, Frances Payne Bolton School of Nursing, Case Western Reserve University; and Molly McNett, MSN, RN, is Research Coordinator, Department of Nursing Research, MetroHealth Medical Center, Cleveland, Ohio.

Corresponding Author: Andrea Adoni, BSN, RN, CCRN, CEN, EMT, Cleveland Metro Lifeflight Office, 4th Floor Hamann, MetroHealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH 44109 (

© 2007 Lippincott Williams & Wilkins, Inc.